Non-steroidal anti-inflammatory drug use in patients with varying severity of coronary artery disease

Purpose We examined temporal trends in NSAID use among patients referred for evaluation of suspected coronary artery disease (CAD). Methods We conducted a drug utilisation study using population-based healthcare data from Western Denmark, covering 3.3 million inhabitants. Three cohorts were categorised based on first-time diagnostic procedure for CAD assessment: coronary computed tomography angiography (CCTA; 2008–2022, n = 91,230), myocardial perfusion imaging (MPI; 2016–2022, n = 17,044), and all invasive coronary angiograms (ICA; 2008–2022, n = 128,327). We calculated the one-year prevalence proportion of NSAID use after the diagnostic procedures, stratified by procedure-defined CAD severity. Results NSAID use declined over the study period, regardless of CAD severity in patients undergoing CCTA or ICA ( p < 0.001). In 2021, the one-year prevalence of NSAID use was 17% among patients with severe CAD vs. 24% among patients without CAD diagnosed using CCTA (prevalence proportion ratio [PPR] 0.73, 95% confidence interval [CI]: 0.60–0.90). In patients undergoing MPI, 9% of those with severe CAD vs. 15% of those with no CAD used NSAIDs (PPR 0.58, 95% CI: 0.45–0.73). In patients undergoing ICA, 10% of those with severe CAD and 20% of those with no CAD used NSAIDs (PPR 0.53, 95% CI: 0.44–0.62). Conclusion Although NSAID use among patients with CAD has decreased and is lower than among patients without CAD, it remains relatively high in those with severe CAD.